Pulmonary function and sleep breathing

Two new targets for type 2 diabetes care

Albert Lecube, Rafael Simó, Maria Pallayova, Naresh M. Punjabi, Carolina López-Cano, Cecilia Turino, Cristina Hernández, Ferran Barbé

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Population-based studies showing the negative impact of type 2 diabetes (T2D) on lung function are overviewed. Among the wellrecognized pathophysiological mechanisms, the metabolic pathways related to insulin resistance (IR), low-grade chronic inflammation, leptin resistance, microvascular damage, and autonomic neuropathy are emphasized. Histopathological changes are exposed, and findings reported from experimental models are clearly differentiated from those described in humans. The accelerated decline in pulmonary function that appears in patients with cystic fibrosis (CF) with related abnormalities of glucose tolerance and diabetes is considered as an example to further investigate the relationship between T2D and the lung. Furthermore, a possible causal link between antihyperglycemic therapies and pulmonary function is examined. T2D similarly affects breathing during sleep, becoming an independent risk factor for higher rates of sleep apnea, leading to nocturnal hypoxemia and daytime sleepiness. Therefore, the impact of T2D on sleep breathing and its influence on sleep architecture is analyzed. Finally, the effect of improving some pathophysiological mechanisms, primarily IR and inflammation, as well as the optimization of blood glucose control on sleep breathing is evaluated. In summary, the lung should be considered by those providing care for people with diabetes and raise the central issue of whether the normalization of glucose levels can improve pulmonary function and ameliorate sleepdisordered breathing. Therefore, patients with T2D should be considered a vulnerable group for pulmonary dysfunction. However, further research aimed at elucidating how to screen for the lung impairment in the population with diabetes in a cost-effective manner is needed.

Original languageEnglish
Pages (from-to)550-573
Number of pages24
JournalEndocrine Reviews
Volume38
Issue number6
DOIs
Publication statusPublished - 1 Dec 2017

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Type 2 Diabetes Mellitus
Sleep
Respiration
Lung
Insulin Resistance
Inflammation
Glucose
Sleep Apnea Syndromes
Leptin
Metabolic Networks and Pathways
Hypoglycemic Agents
Cystic Fibrosis
Population
Blood Glucose
Theoretical Models
Costs and Cost Analysis
Research

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Lecube, A., Simó, R., Pallayova, M., Punjabi, N. M., López-Cano, C., Turino, C., ... Barbé, F. (2017). Pulmonary function and sleep breathing: Two new targets for type 2 diabetes care. Endocrine Reviews, 38(6), 550-573. https://doi.org/10.1210/er.2017-00173

Pulmonary function and sleep breathing : Two new targets for type 2 diabetes care. / Lecube, Albert; Simó, Rafael; Pallayova, Maria; Punjabi, Naresh M.; López-Cano, Carolina; Turino, Cecilia; Hernández, Cristina; Barbé, Ferran.

In: Endocrine Reviews, Vol. 38, No. 6, 01.12.2017, p. 550-573.

Research output: Contribution to journalReview article

Lecube, A, Simó, R, Pallayova, M, Punjabi, NM, López-Cano, C, Turino, C, Hernández, C & Barbé, F 2017, 'Pulmonary function and sleep breathing: Two new targets for type 2 diabetes care', Endocrine Reviews, vol. 38, no. 6, pp. 550-573. https://doi.org/10.1210/er.2017-00173
Lecube, Albert ; Simó, Rafael ; Pallayova, Maria ; Punjabi, Naresh M. ; López-Cano, Carolina ; Turino, Cecilia ; Hernández, Cristina ; Barbé, Ferran. / Pulmonary function and sleep breathing : Two new targets for type 2 diabetes care. In: Endocrine Reviews. 2017 ; Vol. 38, No. 6. pp. 550-573.
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